Technical Field of
This disclosure relates to music systems and especially to music systems used in medical facilities such as surgical operating rooms or hospitals.
Description of the Related Art
Years of medical research, innovation and progress, have resulted in medical indicators for assessing patient risk. When a patient undergoes surgery, professional standards mandate that the patient be connected to monitors that continuously measure heart rate, blood pressure, arterial oxygen saturation, as well as other physiologic parameters. While these vital signs are visually displayed on a monitor screen, readings outside of normal, pre-defined ranges also trigger audio alarms in the monitoring equipment in order to alert medical personnel. However, with conservative parameters these alarm tones are relatively common and sometimes go unnoticed due to desensitization, a syndrome known as “alarm fatigue”. In the operating room, these alarms may be inaudible at times due to excessive levels of noise and therefore may go unnoticed by health care professionals.
In a recent study, Dr. Schlesinger et at assessed the ability of resident anesthesiologists to detect changes in pulse oximetry in a noisy operating room environment. Currently, an anesthesia provider must battle with high levels of ambient noise including powered surgical instruments, suction, forced air warmers, conversation, and background music to try to detect the sounds of the patient's heart rate, oxygen saturation and alarm tones. It should be noted that the operating room setting has notoriously poor room acoustics caused by sound-reflective floor, wall, and ceiling surfaces designed for easy sanitization. Specific challenges are presented by the use of stereo systems, with which most operating rooms are equipped. In the era of iPods and Pandora, it is common for a surgeon to play music of his or her choice during surgery. Because of poor acoustics in an operating room and competing ambient noise, music is sometimes played at high decibel levels so that it can be heard. This poses a risk for important warning tones, pitches, and alarms from the anesthesia monitor becoming inaudible.
The auditory challenges faced by anesthesiologists were discussed in the 2014 article by Jonathan D. Katz, M.D. titled Noise in the Operating Room which appeared in the journal, Anesthesiology. Attached hereto as Appendix A and incorporated by this reference as though fully set forth herein. Katz highlighted some of the issues of noise pollution and alarm fatigue in the operating room setting. A medical team's ability to recognize a vital sign alarm and provide a timely response to that alarm can be the difference between life and death for a patient. Noise pollution compromises the attention of health care professionals and compromises patient safety in the operating room, putting patients at risk. Conservatively programmed monitor alarms become overly familiar to health care professionals, resulting in desensitization and alarm fatigue. Sometimes alarms are simply drowned out by the other sounds in the operating room that can exceed 130 dBA. The music commonly played in the operating room setting can contribute heavily to noise pollution—up to 87 dBA—and reduce the ease and accuracy of performing tasks. See Katz article, http://www.cspsteam.org/noiseanddistraction/NoiseintheOperatingRoom35.pdf. In the operating room, speakers are typically placed far away from patients and work instruments and may not be within ready reach of medical professionals during surgery, particularly when an emergency occurs.
In health care facilities, advances in technology of medical monitors, hospital servers, and electronic health records makes communication between these systems the norm. Live data readings are fed into a patient's medical record during surgery, constantly reporting on vital signs readings and changes. See article title Making Connections attached hereto as Appendix B and incorporated by this reference. Medical monitors can be grouped into three basic categories based on how data is sent from each type of device: episodic, continuous stand-alone, and continuous networked. Other categories and configurations may be possible but these three represent the most common. Additionally, it is possible that some devices may fall into overlapping categories.
In the surgical operating room setting, anesthesia monitors may fall into either continuous stand-alone or continuous networked categories. Because they may be tied to a single location, continuous stand-alone devices may be hard wired to communicate with the hospital network via a wireless or LAN connection. Continuous networked devices, such as physiologic monitoring systems and networked infusion pumps, monitor and/or treat a single patient over an extended period and are connected to a central server supplied by the device vendor. Due to the direct connection, no additional components are required in order for the continuous networked devices to collect and translate data directly to the host server via the hospital network. Continuous stand alone devices, such as a ventilator, are used to continuously monitor and/or treat a single patient over an extended period, but are typically not networked to any vendor-supplied central server (also referred to as a gateway). With the exception of anesthesia and intensive care unit monitors, most vital sign monitors are episodic devices. Episodic devices obtain a single set of measurements such as noninvasive blood pressure, oxygen saturation, temperature, and pulse rate from a patient at any given time. In other words, episodic devices provide spot check readings for a patient at the point of care. Episodic devices are coupled via wired connection with a point of care (POC) component which communicates readings from the device via a wireless network.
While careful attention has been employed in advancing technology for informational and medical equipment, music players for operating rooms have not been provided such attention. In the separate marketplace, music players have evolved. Now, an entire library of music can be housed on a very small device or accessed via a network connection. Internet access and Wi-Fi connectivity prominent in hospitals makes Internet radio or cloud-based libraries immediately accessible. In most instances, a music file is accessed and played through a speaker or speakers. Wired speaker connections like RCA connectors or 3.5 mm cords have been around for decades, but Bluetooth® and wireless speakers are becoming very common. New wireless speaker adapters are making it possible for any speaker system to be a Bluetooth® compatible speaker system which can be connected wirelessly to a music player over long or short ranges. The ready accessibility to music permits surgeons to play any genre of music at any time. Technological convenience has opened the door to allow ease of access to music in the operating room, yet music players are still not crossing over to communicate with the technologically advanced medical monitors and equipment.